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Monday, October 20, 2014

A remarkable story is currently occurring in Canada - again. An aboriginal child is suffering from life-threatening cancer. The type of cancer: leukemia. The odds of success if chemotherapy is instituted in a timely fashion: > 90%. The child in question: an 11 year old girl. The girl dropped out of treatment and left hospital. A second child, also 11 years old, also removed from her parents from hospital under similar circumstances has since experienced a relapse.

In both cases the child in question is an aboriginal child. In both cases the parents decided to take it to some holistic healing center in Florida. To date there is zero empirical evidence that the approach taken by this treatment center treats childhood leukemia successfully.

The hospital in question asked a court to direct the local Children's Aid Society to intervene. Remarkably, the Society, represented by a lawyer, took this stance:

"Handleman, the lawyer for the society, said that appropriate steps were taken and after an investigation it was determined the girl was not a child in need of protection. Handleman also stated that her mother was not refusing treatment for her daughter, but simply chose treatment the doctors disagreed with."

Simple, isn't it? There is an eleven year old child suffering from leukemia, the odds of successful treatment with the gold standard of clinical care under those circumstances: 90%, parents remove child for unproven holistic something, Children's Aid Society doesn't quite see what the fuzz is all about. After all, the parents were willing to provide some sort of treatment to daughter, just not the gold standard of care. Problem solved. It's all relative and truly in the air. There is no discernable difference to the Society between the professional opinion of specialists and the parents.

"Obviously our main concern is with the well-being of this child.… This child has a life-threatening illness [and] without standard treatment will not survive, so our sole focus is trying to bring this child into treatment so we have an opportunity to provide her with a long, healthy life."

That apparently is of no concern to the local Children's Aid Society. Not in a case where an aboriginal parent has other ideas about treatment. Indeed, the mother stresses

"'This was not a frivolous decision I made."

Alas, there is zero evidence that the course of action she is currently following has succeeded, ever!

"But Justice Gethin Edward of the Ontario Court of Justice suggested physicians essentially want to “impose our world view on First Nation culture.” The idea of a cancer treatment being judged on the basis of statistics that quantify patients’ five-year survival rate is “completely foreign” to aboriginal ways, he said.“Even if we say there is not one child who has been cured of acute lymphoblastic leukemia by traditional methods, is that a reason to invoke child protection?” asked Justice Edward, noting that the girl’s mother believes she is doing what is best for her daughter.“Are we to second guess her and say ‘You know what, we don’t care?’ … Maybe First Nations culture doesn’t require every child to be treated with chemotherapy and to survive for that culture to have value.”

This sounds almost farcical. The judge apparently doesn't think child survival is what's at stake, but the value of aboriginal society. A nice sentiment so long as you aren't a vulnerable child desperately needing proven medical care. To be fair, the judge is asking these questions. I hope he'll come to his senses and not judge along those lines. - Surely, the essential question here is this: Should we, as a society override parental care decisions for their children in cases where there is overwhelming evidence that they're harming their children irreversibly, or, as in our case, where the children would die almost certainly?

The long and short of it is that we have always done this. The children's (objective) best (survival) interests trump parental best intentions, parental ignorance, parental fanaticism, parental scepticism with regard to mainstream medicine etc etc. Hospitals routinely override parental decisions by Jehova's Witnesses that refuse life-preserving blood transfusions for their children. And they are right to do so. There is no parental right to kill their children, not even with the best of intentions. Anyone recall the cases of children who died because their parents thought prayers would do the trick?

What is not known is whether these two cases (same hospital) are a result of a communications break-down between the health care professionals and the parents. But even if this was the case, it remains shocking that the Children's Aid Society could possibly justify its inaction with the view that the parents were just trying something different. Since when has the life of a child become so cheap that we leave it to misguided parents who wish to do as they see fit, evidence be damned?

Oh, right, I forgot, it's an aboriginal child. If this is a case of trying to make-up for past injustice, let me just say that this isn't quite a sensible way to go about this matter.